Hydraulic anal incontinence treatment

ABSTRACT

An anal incontinence treatment apparatus and method includes and uses an adjustable restriction device implanted in a patient, who suffers from anal incontinence. The restriction device engages the rectum of the patient to restrict the fecal passageway. An adjustment device is adapted to adjust the restriction device such that the rectum is temporarily released, in order to open the fecal passageway when the patient wishes to achieve defaecation.

CROSS REFERENCE TO RELATED APPLICATION

This application is a continuation of application Ser. No. 09/503,483,filed Feb. 14, 2000 now U.S. Pat. No. 6,482,145, the entire content ofwhich is hereby incorporated by reference in this application.

This application incorporates herein by reference the disclosure ofprovisional application Ser. No. 60/148,345 filed Aug. 12, 1999.

BACKGROUND OF THE INVENTION

The present invention relates to an anal incontinence treatmentapparatus and method. More specifically, the invention relates to ananal incontinence treatment apparatus and method for surgicalapplication in the body of an anal incontinence patient for restrictingthe colon or rectum of a patient.

Anal incontinence is a widespread problem. Many different solutions tothis problem have been tried. Several kinds of sphincter plastic surgeryare used today to remedy anal incontinence. There is a prior manuallyoperated sphincter system in an initial clinical trial phase with thehydraulic sphincter system connected to a reservoir placed in thescrotum. Disadvantage of this system is that hard fibrosis createdaround the reservoir over time may cause malfunction of pumpingcomponents. Thus, the created fibrosis will sooner or later become ahard fibrotic layer which may make it difficult to pump the reservoir.Yet a further disadvantage is that the use of hydraulic fluid alwaysentails a risk of fluid leaking from the prosthetis. Furthermore, it isa rather complicated task to mechanically manually pump the reservoirwhen defaecation is needed. U.S. Pat. No. 5,593,443 discloses hydraulicanal sphincter under both reflex and voluntary control. An inflatableartificial sphincter with the pump system in scrotum is disclosed inU.S. Pat. No. 4,222,377.

SUMMARY OF THE INVENTION

A prime object of the present invention is to provide an analincontinence treatment apparatus, which does not require manualmanipulation of a combined reservoir a pump mechanism placed in thescrotum or labia major a region of the patient.

Another object of the invention is to provide an anal incontinencetreatment apparatus, which does not require complicated surgery.

Yet another object of the invention is to provide an anal incontinencetreatment apparatus, which may be conveniently remotely controlled bythe patient.

Accordingly, the present invention provides an anal incontinencetreatment apparatus, comprising an adjustable restriction deviceimplanted in a patient, who suffers from anal incontinence, and engaginga portion of the colon or rectum of the patient to restrict the fecalpassageway therein, an adjustment device which adjusts the restrictiondevice to restrict the colon or rectum to close the fecal passageway, orrelease the colon or rectum to open the fecal passageway, and a poweredhydraulic operation device for adjusting the adjustment device.

Preferably the hydraulic operation device adjusts the adjustment devicein a non-manual manner. The expression “non-manually manner” should beunderstood to mean that the restriction device is not adjusted bymanually touching subcutaneously implanted components of the apparatusor not manipulated by touching the skin of the patient. Preferably, theadjustment device adjusts the restriction device in a non-invasivemanner. The expression powered should be understood as energised witheverything without manual force, preferable electric energy.

The adjustment device may adjust the restriction device in anon-magnetic manner, i.e. magnetic forces may not be involved whenadjusting the restriction device.

The adjustment device may also adjust the restriction device in anon-thermal manner, i.e. thermal energy may not be involved whenadjusting the restriction device. Furthermore, as opposed to prior artanal incontinence treatment devices the adjustment device of theinvention is not operated by manual forces, such as by manuallycompressing a fluid containing balloon implanted in the scrotum. Insteadthe apparatus of the invention may further comprise a powered operationdevice for operating the adjustment device.

In the various embodiments hereinafter described the restriction devicegenerally forms an at least substantially closed loop. However, therestriction device may take a variety of different shapes, such as theshape of a square, rectangle or ellipse. The substantially closed loopcould for example be totally flat, i.e. thin as seen in the radialdirection. The shape of restriction device may also be changed duringuse, by rotation or movements of the restriction device in anydirection.

Preferably the restriction device controls the size of the area of thefecal passageway in the colon or rectum, preferably to change steplesslywith a preselected size that is satisfactory for the patient.

A control device for controlling the restriction device may convenientlybe provided and may comprise an internal programmable control unitimplanted in the patient and, possibly an external control unit outsidethe patient's body for programming the programmable internal controlunit. Alternatively, the external control unit may be programmable andwirelessly control the restriction device.

At least one sensor for sensing at least one physical parameter of thepatient may conveniently be implanted in the patient. The sensorpreferably senses the pressure against the restriction device or thecolon or rectum or other important parameters and either the internalcontrol unit or the external control unit of the control device maysuitably control the restriction device to release the fecal passageway. For safety the restrictor device may release the fecal passagewayin response to the sensor sensing for example an abnormally highpressure value. The internal control unit may directly controls therestriction device in response to signals by the sensor.

The apparatus preferably comprises a control device which may compriseboth an internal or an external control unit for controlling therestriction device preferable for wirelessly controlling the restrictiondevice. Preferable the implanted internal control unit beingprogrammable by the external control unit. The external control unit mayalso be programmable.

Preferably, a hydraulic operation device, suitably electrically powered,is implanted in the patient for operating the adjustment device and areservoir is also implanted in the patient and contains a predeterminedamount of hydraulic fluid, wherein the hydraulic operation deviceoperates the adjustment device by using the hydraulic fluid of thereservoir.

In accordance with a first main embodiment of the invention, theadjustment device comprises an expandable cavity in the restrictiondevice, the colon or rectum being sqeezed upon expansion of the cavityand released upon contraction of the cavity, and the hydraulic operationdevice distributes hydraulic fluid from the reservoir to expand thecavity, and distributes hydraulic fluid from the cavity to the reservoirto contract the cavity.

A fluid distribution tube may readily be connected between the reservoirand the cavity in a manner so that the tube does not interfere withother implanted components of the apparatus.

Preferably, the reservoir defines a chamber for the predetermined amountof fluid and the hydraulic operation device changes the size of thechamber. The hydraulic operation device suitably comprises first andsecond wall portions of the reservoir, which are displaceable relativeto each other to change the size of the chamber of the reservoir. Thehydraulic operation device may distribute fluid from the reservoir tothe cavity of the restriction member in response to a predeterminedfirst displacement of the first wall portion of the reservoir relativeto the second wall portion of the reservoir and may distribute fluidfrom the cavity to the reservoir in response to a predetermined seconddisplacement of the first wall portion relative to the second wallportion.

The first and second wall portions of the reservoir may be displaceablerelative to each other by manual manipulation, such as by manuallypushing, pulling or rotating any of the wall portions in one direction,or alternatively, may be displaceable relative to each other by a devicepowered magnetically, hydraulically, or electrically (e.g. by anelectric motor). In this embodiment no pump is used, only the volume ofthe reservoir is varied. This is of great advantage compared to thesolution described below when a pump is used to pump fluid between thereservoir and the adjustment device because there is no need for anon-return valve and it is still possible to have fluid going both toand from the reservoir.

The operation device may comprise a fluid conduit, which is devoid ofany non-return valve between the pump and the cavity (including thesame) and the reservoir may form part of the conduit and a fluid chamberwith a variable volume. The pump may distribute fluid from the chamberto the cavity by reduction of the volume of the chamber and withdrawfluid from the cavity by expansion of the volume of the chamber. Theoperation device preferably comprises a motor for driving the pump,which may comprise a movable wall of the reservoir for changing thevolume of the chamber. Any kind of motor could be used for the differentoperations as well as wireless remote solutions.

In accordance with a particular embodiment of the invention, thehydraulic operation device comprises a pump for pumping fluid betweenthe reservoir and the cavity of the restriction device. The pumppreferably comprises a first activation member for activating the pumpto pump fluid from the reservoir to the cavity of the restrictiondevice, and a second activation member for activating the pump to pumpfluid from the cavity to the reservoir. The first and second activationmembers may be operable by manual manipulation thereof, such as bymanually pushing, pulling or rotating any of the activation members inone direction. At least one of the activation members is constructed tooperate when subjected to an external pressure exceeding a predeterminedmagnitude.

As an alternative to the manual manipulation, at least one of the firstand second activating members may be operable by a device poweredmagnetically, hydraulically, or electrically (e.g. by an electricmotor). The pump may pump fluid both to and away from the adjustmentdevice or hydraulic device controlling the adjustment device. Amechanical solution is proposed in which it is possible to pump in bothdirections just by pushing an activating member in one direction.Another alternative is a pump pumping in only one direction and anadjustable valve to change the direction of fluid to either increase ordecrease the amount of fluid in the reservoir. This valve may bemanipulated either manually, mechanically, magnetically, orhydraulically.

Wherever a magnetic means is utilized according to the invention it maycomprise a permanent magnet and a magnetic material reed switch, orother suitable known or conventional magnetic devices.

A physical lumen, like the colon or rectum or the prolongation thereof,is often easier to restrict by contracting at least two opposite ordifferent side walls of the lumen against each other. The expression“colon or rectum or the prolongation thereof” should be understood tomean the rectum extended all the way out to the anal sphincter andfollowing the passage of the large bowel in the other direction. It isalso possible to use only one element and squeeze against human bone ortissue.

Either mechanical or hydraulic solutions may be employed to operate therestriction device. Alternatively, the restriction device may comprisean adjustable cuff, a clamp or a roller for bending the colon or rectumor the prolongation thereof to restrict the fecal passageway therein.Such a cuff, clamp or roller may also be utilized for squeezing thecolon or rectum or the prolongation thereof against human materialinside the body of the patient for an example the sacral bone of thepatient.

Advantageously, the forming means may form the restriction member into aloop having a predetermined size.

The adjustment device may change the size of the restriction openingsuch that the outer circumferential confinement surface of therestriction member either is changed or is unchanged.

Preferable the restriction device comprises an elongated restrictionmember and forming means for forming the restriction member into atleast a substantially closed loop around the colon or rectum or it'sprolongation, the loop defining a restriction opening, whereby theadjustment device adjusts the restriction member in the loop to changethe size of the restriction opening.

The elongated restriction member may be flexible, for example take theshape of a belt or a cord, and the adjustment device may pull a firstportion of the flexible restriction member from a second portion of theflexible restriction member opposite the first portion in the loop tosqueeze the colon or rectum or the prolongation thereof between twoopposite lengths of the elongated flexible restriction member torestrict the fecal passageway. The restriction member may benon-inflatable, and the adjustment device may mecanically adjust therestriction member in the loop.

In accordance with a particular embodiment of the invention, theadjustment device mechanically adjusts the restriction device. Thus, therestriction device may comprise two or more elements on different sidesof the colon or rectum, and the adjustment device may squeeze the colonor rectum or the prolongation thereof between the elements to restrictthe fecal passageway.

In accordance with an alternative, the restriction device may comprisetwo articulated clamping elements positioned on opposite sides of thecolon or rectum or the prolongation thereof, and the adjustment devicemay move the clamping elements towards each other to clamp the rectumbetween the clamping elements to restrict the fecal passageway.

In accordance with another alternative, the restriction device may bendthe colon or rectum or the prolongation thereof. For example, therestriction device may comprise at least two bending members, such ascylindrical or hour-glass shaped rollers, positioned on opposite sidesof the colon or rectum or the prolongation thereof, and the adjustmentdevice may move the bending members against the esophagus or stomach tobend the latter to decrease the the colon or rectum or the prolongationthereof in two opposite spaced apart directions to bend the colon orrectum or the prolongation thereof to restrict the fecal passageway. Thebending or rotating members may have any shape or form and be eitherhydralic or non-inflatable.

In accordance with another particular embodiment of the invention, thehydraulic operation device comprises a servo means, suitably includinghydraulic means. Alternatively, the servo means may include magnetic orelectric means. Preferably, the servo means comprises a servo reservoirdefining a chamber containing servo fluid and the hydraulic operationdevice comprises first and second wall portions of the servo reservoir,which are displaceable relative to each other to change the size of thechamber of the servo reservoir. The same principle will apply for theservo reservoir as for the earlier described reservoir wherein thevolume in the servo reservoir may be increased or decreased by a firstor second displacement of the first wall portion relative to the secondwall portion of the servo reservoir and thereby control the earlierdescribed reservoir and thereby indirectly control the fecal passageway.The first and second wall portions of the servo reservoir may bedisplaceable relative to each other by manual manipulation, such as bymanually pushing, pulling or rotating any of the wall portions of theservo reservoir in one direction. Alternatively, the first and secondwall portions may be displaceable by magnetically, hydraulically orelectrically powered devices. These powered devices may all be activatedby manual manipulating means preferably located subcutaneously. Thisactivation may be indirect, for example via a switch.

Especially when manual manipulation means are used, the servo means issuitable to use. With servo means less force is needed for controllingthe adjustment device. Hydraulic operation is preferably used with theservo means. One example is a closed system that controls another closedsystem in which hydraulic components of the adjusment device areincorporated. Minor changes in the amount of fluid in a reservoir of thefirst system could then lead to major changes in the amount of fluid ina reservoir in the second system. Consequently, the change in volume inthe reservoir of the second system affects the hydraulic operation ofthe adjustment device which is incorporated in the second closed system.The great advantage of such a servo means is that the larger volumesystem could be placed at a suitable location, e.g. inside the abdomenwhere there is more space, and still it would be possible to use manualmanipulation means of the smaller system subcutaneously. The servoreservoir could control the reservoir of the larger volume.

The servo reservoir could be controlled directly or indirectly by asmall fluid supply reservoir, which may be placed subcutaneously and maybe activated by manual manipulation means controlling the servoreservoir or other suitable device.

Preferably, the hydraulic operation device comprises first and secondwall portions of the fluid supply reservoir, which are displaceablerelative to each other to change the size of the chamber of the fluidsupply reservoir. The hydraulic operation device may distribute fluidfrom the fluid supply reservoir to the servo reservoir in response to apredetermined first displacement of the first wall portion of the fluidsupply reservoir relative to the second wall portion of the fluid supplyreservoir and to distribute fluid from the servo reservoir to the fluidsupply reservoir in response to a predetermined second displacement ofthe first wall portion relative to the second wall portion. The wallportions of the fluid supply reservoir may be displaceable relative toeach other by manual manipulation means or be displaceable relative toeach other by manual manipulation means for pushing, pulling, orrotating any of the wall portions of the fluid supply reservoir in onedirection. Alternatively, the wall portions of the fluid supplyreservoir may be displaceable relative to each other by magnetic means,hydraulic means, manually manipulated means, or electrical control meansincluding an electric motor. The magnetic means, hydraulic means, orelectrical control means may all be activated by manually manipulatedmeans preferably located subcutaneously. This control may be indirect,for example via a switch.

Even in the broadest embodiment of the invention the adjustment devicemay comprise a servo means. The servo means may comprise a hydraulicmeans, an electric control means, a magnetic means, mechanical means, ora manual manipulating means. The hydraulic means, electric controlmeans, mechanical means or magnetic means may be activated by manualmanipulating means. Using a servo system will save the use of force whenadjusting the adjustment device which may be of importance in manyapplications.

All systems according to the invention may be controlled by a wirelessremote control.

In accordance with an advantageous embodiment of the invention, there isprovided a wireless remote control for controlling the restrictiondevice. The remote control may conveniently comprise an externalhand-held remote control unit which is manually operable by the patientto control the restriction device to squeeze and release the colon orrectum or the prolongation thereof. The remote control mayadvantageously be capable of obtaining information on pressure or otherimportant parameters such as the pressure against the restriction deviceand of commanding the operation device to operate the adjustment deviceto adjust the restriction device in response to obtained information.With the remote control the apparatus of the invention is convenientlycontrolled to adjust the implanted restriction device, which controlsthe restriction of the fecal passageway and wherein the restrictiondevice is operable to open and close the fecal passageway. With theremote control the restriction device may steplessly controls thecross-sectional area of the passageway.

The apparatus of the invention may further comprise a pressure sensorfor directly or indirectly sensing the pressure against the restrictiondevice and the control device may control the restriction device inresponse to signals from the pressure sensor. The adjustment devicepreferably non-invasively adjusts the restriction device to change thesize of the cross-sectional area.

The adjustment device or other energy consuming components of theapparatus may also be energised with wirelessly transmitted energy fromoutside the patient's body or with with an implanted battery oraccumulator.

The apparatus may further comprise an implanted energy transfer device,wherein the control device releases electric energy and the energytransfer device transfers the electric energy directly or indirectlyinto kinetic energy for operation of the restriction device.

The remote control comprises means for wireless transfer of energy fromoutside the patient's body to energy consuming implanted components ofthe apparatus. A motor may suitably be implanted for operating theoperation device and the means for wireless transfer of energy maydirectly power the motor with transferred energy. The energy transferredby the means for transfer of energy may comprise a wave signal, anelectric field or a magnetic field. Preferably, the wireless remotecontrol comprises an external signal transmitter and an implanted signalreceiver. For example, the signal transmitter and signal receiver maytransmit and receive a signal in the form of digital pulses, which maycomprise a magnetic or electric field. Alternatively, which ispreferred, the signal transmitter and signal receiver may transmit andreceive a wave signal, which may comprise an electromagnetic wavesignal, a sound wave signal or a carrier wave signal for a remotecontrol signal. The receiver may comprise a control unit for controllingthe hydraulic operation device in response to signals from the signaltransmitter.

The apparatus of the invention may further comprise an implantedenergizer unit for providing energy to implanted energy consumingcomponents of the apparatus, such as electronic circuits and/or a motorfor operating the operation device. The control unit may power such animplanted motor with energy provided by the energizer unit in responseto a control signal received from the signal transmitter. Any known orconventional signal transmitting or signal receiving device that issuitable for use with a human or mammal patient may be provided as thesignal transmitter or signal receiver. The control signal may comprisean electromagnetic wave signal, such as an infrared light signal, avisible light signal, a laser light signal, a microwave signal, or asound wave signal, such as an ultrasonic wave signal or an infrasonicwave signal, or any other type of wave signals. The control signal mayalso comprise electric or magnetic fields, or pulses. All of theabove-mentioned signals may comprise digital signals. The controlsignals may be carried by a carrier signal, which may be the same as thewireless energy signal. Preferably, a digital control signal may becarried by an electromagnetic wave signal. The carrier signal or controlsignal may be amplitude or frequency modulated.

The motor may be any type of motor, such as a pneumatic, hydraulic orelectric motor and the energizer unit may power the motor withpressurized gas or liquid, or electric energy, depending on the type ofmotor. Where the motor is an electric motor, it may power pneumatic orhydraulic equipment. In all embodiments a motor may be operativelyconnected to the adjustment device and the control of the motor may beeffected by a reversing device implanted in the patient for reversingthe function performed by the motor. The reversing device implanted inthe patient may also reverse the function performed by the restrictiondevice.

The adjustment device preferably in all embodiments adjusts therestriction device in a non-manual manner without touching the skin ofthe patient.

The energizer unit may comprise a power supply and the control unit maypower the motor with energy from the power supply. Preferably, the powersupply is an electric power supply, such as a battery, and the motor isan electric motor. In this case, the battery also continuously powersthe circuitry of the signal receiver between the adjustment operations,in order to keep the signal receiver prepared for receiving signalstransmitted from the signal transmitter.

The energizer unit may transfer energy from the control signal, as thelatter is transmitted to the signal receiver, into electric energy forpowering the implanted electronic components. For example, the energizerunit may transfer the energy from the control signal into direct oralternating current.

In case there is an implanted electric motor for operating the operationdevice the energizer unit may also power the motor with the transferredenergy. Advantageously, the control unit directly powers the electricmotor with electric energy, as the energizer unit transfers the signalenergy into the electric energy. This embodiment is particularly simpleand does not require any recurrent invasive measures for exchangingempty power supplies, such as batteries, that is required in the firstembodiment described above.

For adjustment devices of the type that requires more, but stillrelatively low, power for its operation, the energizer unit may comprisea rechargeable electric power supply for storing the electric energyobtained and the control unit may power the electric motor with energyfrom the rechargeable electric power supply in response to a controlsignal received from the signal transmitter. In this case, therechargeable power supply can be charged over a relatively long time(e.g. a few seconds up to a half hour) without powering the electricmotor.

The electric power supply suitably comprises an inexpensive simplecapacitor. In this case, the electric motor may be a stepping motor.

The signal transmitter may transmit an electromagnetic signal and theenergizer unit may draw radiant energy from the electromagnetic wavesignal, as the latter is transmitted to the signal receiver, andtransfer the radiant energy into electric energy.

Alternatively, the energizer unit may comprise a battery, anelectrically operable switch adapted to connect the battery to thesignal receiver in an on mode when the switch is powered and to keep thebattery disconnected from the signal receiver in a standby mode when theswitch is unpowered and a rechargeable electric power supply forpowering the switch. The control unit may power the electric motor withenergy from the battery in response to a control signal received fromthe signal transmitter, when the switch is in its on mode.Advantageously, the energizer unit may transfer wave energy from thecontrol signal, as the latter is transmitted to the signal receiver,into a current for charging the rechargeable electric power supply,which suitably is a capacitor. Energy from the power supply is then usedto change the switch from off (standby mode) to on. This embodiment issuited for adjustment devices of the type that require relatively highpower for their operation and has the advantage that the electroniccircuitry of the signal receiver does not have to be powered by thebattery between adjustments. As a result, the life-time of the batterycan be significantly prolonged. The switch may be switched withmagnetic, manual or electric energy. Preferable the switch is controlledby wireless energy.

As an example, the signal transmitter may transmit an electromagneticwave signal and the energizer unit may draw radiant energy from theelectromagnetic wave signal, as the latter is transmitted to the signalreceiver, and may transfer the radiant energy into the current. Theenergizer unit suitably comprises a coil of the signal receiver forinducing an alternating current as the electromagnetic wave signal istransmitted through the coil and a rectifier for rectifying thealternating current. The rectified current is used for charging therechargeable power source.

Alternatively, the signal transmitter and receiver may solely be usedfor a control signal and a further pair of signal transmitter andreceiver may be provided for transferring signal energy to implantedcomponents. By such a double system of signal transmitters and receiversthe advantage is obtained that the two systems can be designed optimallyfor their respective purposes, namely to transmit a control signal andto transfer energy from an energy signal. Accordingly, the apparatus mayfurther comprise an external energy transmitter for transmittingwireless energy, wherein the energizer unit comprises a battery and anoperable switch for connecting the battery to the signal receiver in anon mode when the switch is powered and for keeping the batterydisconnected from the signal receiver in a standby mode when the switchis unpowered, and the external energy transmitter powers the switch.Suitably, the energy transmitter may directly power the switch with thewireless energy to switch into the on mode.

As should be realized by a skilled person, in many of theabove-described embodiments of the invention the adjustment device maybe operated by control means or manual manipulation means implantedunder the skin of the patient, such as a pump, an electrical switch or amechanical movement transferring means. In the manual embodiment it isnot necessary to use a motor for operating the adjustment device.

In accordance with an alternative aspect of the present invention ahydraulic adjustment device adjusts the restriction device totemporarily squeeze the colon or rectum or the prolongation thereof bymeans of more than one restriction members to restrict the fecalpassageway.

In accordance with a further alternative aspect of the present inventionit provides an anal incontinence treatment apparatus, comprising anadjustable restriction device implanted in a patient, who suffers fromanal incontinence, the restriction device having two restriction membersengaging the colon or rectum or the prolongation thereof of the patientto engage the fecal passageway. An adjustment device adjusts therestriction device to temporarily release the colon or rectum or theprolongation thereof and normally to restrict the fecal passageway, andpreferable an electrically powered operation device operates theadjustment device in a non-manual manner.

In accordance with another alternative aspect of the present inventionthere is provided two holding members, one placed more distal than theother, comprising two at least substantially closed loops may be rotatedin opposite direction to each other. With interconnecting material forexample flexible bands between the holding members a restriction willoccure between the holding members when they are rotated.

The restriction device may in all applicable embodiments have any shapeor form and be either hydralic or non-inflatable.

Preferably the adjustment device may be engergised directly withwirelessly transmitted energy from outside the patient's body.Preferable, the inplanted energy transfer device transfers wirelessenergy directly or indirectly into kinetic energy for operation of therestriction device. In another embodiment it would also be possible touse an implanted accumulator or battery and control this implantedenergy source from outside the patient's body to supply energy to theadjustment device or other energy consuming parts of the implantedapparatus.

It should be understood that all the applicable embodiments in thisapplication may be combined to achieve alternative embodiments of theinvention.

The above described embodiments according to the general aspect of theinvention may also be implemented in the described embodiments accordingto the alternative aspects of the invention, where applicable.

The invention also provides a method for treating a patient sufferingfrom anal incontinence comprising surgically implanting in the body ofthe an adjustable restriction device which directly engages the colon orrectum to restrict the fecal passageway therein, normally closed, andwhen desired, mechanically adjusting the restriction device totemporarily open the fecal passageway.

The adjustable restriction device may preferably be inplanted in thebase or prolongation of the patients rectum. It is possible to use oneor several restricting devices engaging the colon or rectum.

In accordance with the invention, there is further provided a method fortreating anal incontinence, comprising the steps of placing at least twolaparascopical trocars in the body of a patient suffering from analincontinence, inserting a dissecting tool through the trocars anddissecting an area of the colon or rectum in the abdominal or pelvic orretroperitoneal surroundings, placing at least one adjustablerestriction device in the dissected area engaging the rectum or colon,adjusting the restriction device to normally restrict the fecalpassageway in the rectum or colon, and adjusting the restriction deviceto open the fecal passageway when the patient wants to relieve himselfor herself. A hydraulic adjustable restriction device may be used whenpracticing this method, preferably in a non-manual manner, i.e. withouttouching subcutaneously implanted components of the apparatus.

The method may further comprise implanting a source of energy in thepatient and providing a control device for controlling the source ofenergy from outside the patient's body to supply energy to therestriction device.

The present invention also provides a method for treating analincontinence, comprising surgically implanting in the body of a patientsuffering from anal incontinence an adjustable restriction deviceengaging the colon or rectum or the prolongation thereof to engage thefecal passageway, and when desired to achieve defaecation, adjusting therestriction device to temporarily release the colon or rectum or theprolongation thereof to open the fecal passageway. The method mayfurther comprise implanting an elongated restriction member of therestriction device around the colon or rectum or the prolongationthereof.

In all applications the operation device may be electrically powered.

A further method for treating anal incontinence, comprises surgicallyimplanting in the body of a patient suffering from anal incontinence atleast one adjustable restriction devices to affect the fecal passagewayengaging respective of the colon or rectum or the prolongation thereof,and when desired to achieve defaecation, non-manually without touchingthe skin of the patient adjusting the powered restriction device totemporarily release the colon or rectum or the prolongation thereof toopen the fecal passageway.

The anal incontinence treatment apparatus may also be laparoscopicllyimplanted. Thus, in accordance with the invention there is also provideda method comprising placing at least two laparascopical trocars in thebody of a patient suffering from anal incontinence, inserting adissecting tool through the trocars, dissecting an area of the pelvic orabdominal or retroperitoneal surroundings, and placing an adjustablerestriction device in the dissected area in engagement with the colon,rectum or the prolongation thereof to restrict the fecal passageway.

The adjustment device may perferable be powered preferable withelectricity and operated in a non-manual manner without touching thepatients skin.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-D are block diagrams of four different principal embodiments ofthe anal incontinence treatment apparatus according to the invention.

FIG. 2A-D are cross-sectional views of a pump mechanism according toFIG. 1C, which is designed to pump fluid in opposite directions bymechanically pushing a wall portion in only one direction.

FIG. 3 is a cross-sectional view of a reservoir having a variable volumecontrolled by a remote control motor, in accordance with a particularembodiment of the principal embodiment shown in FIG. 1B or 2B.

FIG. 4 is a cross-sectional view of a reservoir having a variable volumeadjustable by manual manipulation, in accordance with a particularembodiment of the principal embodiment shown in FIG. 1B or 1D.

FIG. 5A is a perspective view of a hydraulic, pneumatic or mechanicalservo system in accordance with a particular embodiment of the principalembodiment shown in FIG. 1D.

FIG. 5B is a cross-sectional view taken along line VB-VB of FIG. 5A.

FIG. 6 is a block diagram illustrating remote control components of thedevice of the invention;

FIG. 7 is a schematic view of exemplary circuitry used for the blockdiagram in FIG. 4;

FIG. 8 is a schematic view of a band with a cavity defining arestriction opening for use in accordance with the invention.

FIGS. 9A and 9B are schematic views of a first mechanical restrictiondevice for use in accordance with the invention;

FIGS. 10A and 10B are schematic views of a second mechanical restrictiondevice for use in accordance with the invention;

FIG. 11 is a schematic view of a third mechanical restriction device foruse in accordance with the invention;

FIG. 12A is a schematic front view of a fourth mechanical restrictiondevice for use in accordance with the invention;

FIGS. 12B and 12C are sectional views along the line A-A of FIG. 12A;

FIGS. 13A through 17B are five modifications of the embodiment of FIGS.12A-12C;

FIG. 18 is a view of an inflatable restriction device of the apparatusof the invention: and

FIG. 19 illustrates the apparatus of the invention implanted in apatient.

DETAILED DESCRIPTION OF THE DRAWINGS

Referring to the drawing figures, like reference numerals designateidentical or corresponding elements throughout the several figures.

FIGS. 1A-D is a block diagram of four different embodiments of the analincontinence treatment apparatus according to the invention. FIG. 1Ashows an elongated restriction member in the form of a band 2 forming aloop which defines a restriction opening. The band 2 provides arestricted fecal passageway in the rectum when applied around thelatter. FIG. 1A further shows a separate reservoir 4, a one way pump 6and an alternate valve 8. FIG. 1B shows the band 2 and a fluid supplyreservoir 10. FIG. 1C shows the band 2, a two way pump 12 and thereservoir 4. FIG. 1D shows a servo system with a first closed systemcontrolling a second system. The servo system comprises the fluid supplyreservoir 10 and a servo reservoir 14. The servo reservoir 14 controls alarger adjustable reservoir 16 which in connection with the band 2applied around the rectum varies the volume of a cavity in the band,which in turn varies the restricted fecal passageway in the rectum. Sucha band 2 forming the restriction opening 3 is illustrated schematicallyin FIG. 8. The band 2 comprises an adjustment device having anexpandable/contractabe cavity 5 which is expanded or contracted bysupplying hydraulic fluid (e.g. from reservoir 4, 6, 10, or 16), and theband 2 may be sutured in place, illustrated schematically at 7 in FIG.8.

FIGS. 2A-D are cross-sectional views of a pump mechanism adapted to pumpfluid in both directions only by mechanically pushing a separate sealingwall portion 18 in one direction. FIG. 2A shows a piston 20 pushedforwards against a spring 22 towards the wall portion 18 and located ina pump housing 24 conducting fluid from a right upper fluid passage 26of the housing 24 to a left fluid passage 28 of the housing 24. A mainvalve 30 is open and a nonreturn valve 32 is closed. FIG. 2B illustratesthe first pump movement in which the piston 20 has moved forwards andreaches the wall portion 18. FIG. 2C illustrates how the piston 20 movesbackwards by the action of the spring 22. The main valve 30 is nowclosed and the nonreturn valve 32 is open for fluid from the right upperpassage 26. FIG. 1D illustrates how the piston 20 is moved furtherdownwards from its position according to FIG. 2B while pushing the wallportion 18 downwardly against a second spring 34 that is stronger thanspring 22, whereby fluid escapes from a right lower fluid passage 36.When moving the piston 20 backwardly from the position according to FIG.2D, fluid enters the left fluid passage 28 and a valve 38 in the lowerright fluid passage 36 closes.

FIG. 3 is a cross-sectional view of a reservoir 40 defining a chamber42, the size of which is variable and is controlled by a remotecontrolled electric motor 44, in accordance with FIG. 1B or 1D. Thereservoir 40 and the motor 44 are placed in a housing 46. The chamber 42is varied by moving a large wall 48. The wall 48 is secured to a nut 50,which is threaded on a rotatable spindle 52. The spindle 52 is rotatedby the motor 44 via an angular gearing, which comprises two conical gearwheels 54 and 56 in mesh with each other. The motor 44 is powered by abattery 58 placed in the housing 46. An signal receiver 60 forcontrolling the motor 44 is also placed in the housing 46.Alternatively, the battery 58 and the signal receiver 60 may be mountedin a separate place. The motor 44 may also be powered by energytransferred from transmitted signals.

FIG. 4 is a cross-sectional view of a reservoir 62 defining a chamber64, the size of which is variable and is controlled by manualmanipulation. A gable wall portion 66 of an open ended inner cylindricalhousing 68 is adapted to be pushed downwards to fit in a desired lockinggroove 70 of a plurality of locking grooves 70 on the mantle wall of thecylindrical housing 68, to reduce the size of the chamber 64. The innercylindrical housing 68 is suspended by springs 72 and is telescopicallyapplied on an outer cylindrical housing 74. When pushing the innercylindrical housing 68 it moves downwards relative to the outercylindrical housing 74 causing the gable wall portion 66 to release fromthe locking groove 70 and move upwards relative to the inner cylindricalhousing 68. When the inner housing 68 is moved upwardly by the action ofthe springs 72 the size of the chamber 64 is increased.

FIGS. 5A and 5B show a servo means comprising a main ring-shaped fluidreservoir 76 defining a chamber 78, the size of which is variable.Centrally positioned in the main ring-shaped reservoir 76 there is aservo fluid reservoir 80 defining a chamber 82, the size of which isvariable. The chamber 82 of the servo reservoir 80 is substantiallysmaller than the chamber 78 of the main reservoir 76. The two reservoirs76 and 80 are situated between two opposite separate walls 84 and 86,and are secured thereto. When changing the amount of fluid in the servoreservoir 80, the two opposite walls 84,86 are moved towards or awayfrom each other, whereby the size of the chamber 78 of the mainreservoir 76 is changed.

FIG. 6 shows the basic parts of a remote control system of the apparatusof the invention including the electric motor 44 of the embodiment shownin FIG. 3. In this case, the remote control system is based on thetransmission of electromagnetic wave signals, often of high frequenciesin the order of 100 kHz-1 gHz, through the skin 130 of the patient. InFIG. 6, all parts placed to the left of the skin 130 are located outsidethe patient's body and all parts placed to the right of the skin 130 areimplanted. Any suitable remote control system may be used.

An external signal transmitting antenna 132 is to be positioned close toa signal receiving antenna 134 implanted close to the skin 130. As analternative, the receiving antenna 134 may be placed for example insidethe abdomen of the patient. The receiving antenna 134 comprises a coil,approximately 1-100 mm, preferably 25 mm in diameter, wound with a verythin wire and tuned with a capacitor to a specific high frequency. Asmall coil is chosen if it is to be implanted under the skin of thepatient and a large coil is chosen if it is to be implanted in theabdomen of the patient. The transmitting antenna 132 comprises a coilhaving about the same size as the coil of the receiving antenna 134 butwound with a thick wire that can handle the larger currents that isnecessary. The coil of the transmitting antenna 132 is tuned to the samespecific high frequency as the coil of the receiving antenna 134.

An external control unit 136 comprises a microprocessor, a highfrequency electromagnetic wave signal generator and a power amplifier.The microprocessor of the control unit 136 is adapted to switch thegenerator on/off and to modulate signals generated by the generator tosend digital information via the power amplifier and the antennas132,134 to an implanted control unit 138. To avoid that accidentalrandom high frequency fields trigger control commands, digital signalcodes are used. A conventional keypad placed on the external controlunit 136 is connected to the microprocessor thereof. The keypad is usedto order the microprocessor to send digital signals to either increaseor decrease the size of the restriction opening defined by the loop ofthe restriction member 2. The microprocessor starts a command byapplying a high frequency signal on the antenna 132. After a short time,when the signal has energized the implanted parts of the control system,commands are sent to increase or decrease the size of the restrictionopening of the restriction member 2 in predefined steps. The commandsare sent as digital packets in the form illustrated below.

Start pattern, 8 bits Command, 8 bits Count, 8 bits Checksum, 8 bitsThe commands are sent continuously during a rather long time period(e.g. about 30 seconds or more). When a new increase or decrease step isdesired the Count byte is increased by one to allow the implantedcontrol unit 138 to decode and understand that another step is demandedby the external control unit 136. If any part of the digital packet iserroneous, its content is simply ignored.

Through a line 140, an implanted energizer unit 126 draws energy fromthe high frequency electromagnetic wave signal received by the receivingantenna 134. The energizer unit 126 stores the energy in a power supply,such as a large capacitor, powers the control unit 138 and powers theelectric motor 44 via a line 142.

The control unit 138 comprises a demodulator and a microprocessor. Thedemodulator demodulates digital signals sent from the external controlunit 136. The microprocessor of the control unit 138 receives thedigital packet, decodes it and, provided that the power supply of theenergizer unit 126 has sufficient energy stored, sends a signal via asignal line 144 to the motor 44 to either increase or decrease the sizeof the restriction opening of the restriction member 2 depending on thereceived command code.

Alternatively, the energy stored in the power supply of the energizerunit may only be used for powering a switch, and the energy for poweringthe motor 44 may be obtained from another implanted power source ofrelatively high capacity, for example a battery. In this case the switchis adapted to connect the battery to the control unit 138 in an on modewhen the switch is powered by the power supply and to keep the batterydisconnected from the control unit in a standby mode when the switch isunpowered.

With reference to FIG. 7, the remote control system schematicallydescribed above will now be described in accordance with a more detailedembodiment. The external control unit 136 comprises a microprocessor146, a signal generator 148 and a power amplifier 150 connected thereto.The microprocessor 146 is adapted to switch the signal generator 148on/off and to modulate signals generated by the signal generator 148with digital commands that are sent to implanted components of the analincontinence apparatus. The power amplifier 150 amplifies the signalsand sends them to the external signal transmitting antenna 132. Theantenna 132 is connected in parallel with a capacitor 152 to form aresonant circuit tuned to the frequency generated by the signalgenerator 148.

The implanted signal receiving antenna coil 134 forms together with acapacitor 154 a resonant circuit that is tuned to the same frequency asthe transmitting antenna 132. The signal receiving antenna coil 134induces a current from the received high frequency electromagnetic wavesand a rectifying diode 160 rectifies the induced current, which chargesa storage capacitor 158. A coil 156 connected between the antenna coil134 and the diode 160 prevents the capacitor 158 and the diode 160 fromloading the circuit of the signal receiving antenna 134 at higherfrequencies. Thus, the coil 156 makes it possible to charge thecapacitor 158 and to transmit digital information using amplitudemodulation.

A capacitor 162 and a resistor 164 connected in parallel and a diode 166forms a detector used to detect amplitude modulated digital information.A filter circuit is formed by a resistor 168 connected in series with aresistor 170 connected in series with a capacitor 172 connected inseries with the resistor 168 via ground, and a capacitor 174, oneterminal of which is connected between the resistors 168,170 and theother terminal of which is connected between the diode 166 and thecircuit formed by the capacitor 162 and resistor 164. The filter circuitis used to filter out undesired low and high frequencies. The detectedand filtered signals are fed to an implanted microprocessor 176 thatdecodes the digital information and controls the motor 44 via anH-bridge 178 comprising transistors 180,182,184 and 186. The motor 44can be driven in two opposite directions by the H-bridge 178.

The microprocessor 176 also monitors the amount of stored energy in thestorage capacitor 158. Before sending signals to activate the motor 44,the microprocessor 176 checks whether the energy stored in the storagecapacitor 158 is enough. If the stored energy is not enough to performthe requested operation, the microprocessor 176 waits for the receivedsignals to charge the storage capacitor 158 before activating the motor44.

FIGS. 9A and 9B show an embodiment of the apparatus of the inventioncomprising a restriction device 202 having an elongated flexiblerestriction member 204, such as a belt, a cord or the like. The flexiblemember 204 extends in a loop around the rectum. (Alternatively, theflexible member 204 may comprise two separate parts on opposite sides ofthe rectum.) One portion 204A of member 204 is attached to a frame 208and another portion 204B of member 204 opposite portion 204A in the loopof the flexible member 204 is connected to an adjustment device 210,which is fixed to the frame 208. The adjustment device 210 pulls theflexible member 204 away from portion 204A to squeeze the rectum betweentwo opposite lengths of the flexible member 204 to thereby restrict thefecal passageway, see FIG. 96A, and releases the rectum from theflexible member 204 to thereby increase the fecal passageway, see FIG.9B.

FIGS. 10A and 10B show an embodiment of the apparatus of the inventioncomprising a restriction device 212 having two plate or bar elements 214on opposite sides of the rectum 206. An adjustment device 216 moves theelements 212 in parallel towards each other to squeeze the rectum 206between the elements 212 to thereby restrict the fecal passageway, seeFIG. 10A, and moves the elements 212 away from each other to increasethe fecal passageway, see FIG. 10B.

FIG. 11 shows an embodiment of the apparatus of the invention comprisinga restriction device 218 having two articulated clamping elements 220positioned on opposite sides of the rectum 206. An adjustment device 222moves the clamping elements 220 toward each other to clamp the rectum206 between the clamping elements 220 to thereby restrict the fecalpassageway, and moves the clamping elements 220 away from each other torelease the rectum 206 from the clamping elements 220 to therebyincrease the fecal passageway.

FIGS. 12A, 12B and 12C show an embodiment of the apparatus of theinvention comprising a restriction device 224 having three bendingmembers in the form of cylindrical rollers 226, 228 and 230 displacedrelative one another in a row along the rectum 206 and positionedalternately on opposite sides of the rectum 206. (Alternatively, eachroller 226, 228 and 230 may take the shape of an hour-glass.) Anadjustment device 232 moves the two outer rollers 226,230 laterallyagainst the rectum 206 in one direction and the intermediate roller 228against the rectum 206 in the opposite direction to bend the rectum tothereby restrict the fecal passageway, see FIG. 12B. To release therectum from the rollers 226-230, the adjustment device 232 moves therollers 226-230 away from the rectum 206, see FIG. 12C.

FIGS. 13A through 17B schematically illustrates modifications of theabove embodiment according to FIGS. 12A-12C. Thus, FIGS. 13A and 13Bshow an embodiment similar to that of FIGS. 12A-12C except that thebending members are oval and not rotatable. FIGS. 14A and 14B show anembodiment similar to that of FIGS. 13A and 13B except that the ovalbending members are rotatable to squeeze the rectum, see FIG. 14B, andto release the rectum, see FIG. 14A. FIGS. 15A and 15B show anembodiment similar to that of FIGS. 12A-12C except that the intermediateroller has a changeable diameter to squeeze the rectum, see FIG. 15B,and to release the rectum, see FIG. 15A. FIGS. 16A and 16B show anembodiment similar to that of FIGS. 10A-10C except that the elements arereplaced by two cylindrical rollers positioned on opposite sides of therectum. Finally, FIGS. 17A and 17B show an embodiment substantiallysimilar to that of FIGS. 16A and 16B except that the restriction deviceis turned 90_to form a S-shaped curvature of the rectum.

FIG. 18 shows an example of a hudraulic restriction device 234 for usein accordance with the invention. The restriction device 234 comprisesan elongated restriction member 236 having an inflatable cavity 238. Atube 240 connects the cavity 238 to a hydraulic fluid reservoir, notshown. The restriction member 236 may be wrapped around the rectum.

FIG. 19 schematically illustrates how any of the above-describedembodiments of the anal incontinence treatment apparatus of theinvention can be implanted in a patient. Thus, an implanted adjustablehydraulic restriction device 234 extends almost completely around therectum 242 to be capable of squeezing the rectum 242 as a single unit.An adjustment device in the form of an inflatable cavity in therestriction device 234 is adapted to adjust the restriction device 234so that the fecal passageway is restricted. An implanted assembly 246includes a hydraulic fluid reservoir and an operation device (which mayinclude a pump) for distributing hydraulic fluid between the reservoirand the inflatable/contractible cavity of the restriction device 234 viaa fluid conduit 240. A wireless remote control of the apparatuscomprises an external signal transmitter 248, which may comprise ahand-held unit, and an implanted signal receiver, which is incorporatedin the implanted assembly 246, includes a control unit for controllingthe restriction device 234 in response to a control signal from theexternal transmitter. The signal receiver of the assembly 246 furtherincludes an energizer unit which transfers energy from the controlsignal transmitted by the external transmitter into electric energy forenergy consuming implanted components of the apparatus.

A pressure sensor 250 is implanted for sensing the pressure on therestriction device 234. The control unit of the signal receiver of theimplanted assembly 246 controls the restriction device 436 to releasethe restriction device 434 in response to the pressure sensor 439sensing an abnormal high pressure.

There are a number of conceivable alternative embodiments of theinvention that give the same result as the above-described embodiments.For example, the microprocessor of the external and implanted,respectively, control units may be replaced by discrete components. Thepower amplifier of the external control unit may be omitted if thesignals generated by the signal generator are strong enough. Therefore,the invention is to be accorded the broadest interpretation of theappended claims to encompass all equivalent structures and assemblies.

1. An anal incontinence disease treatment apparatus, comprising: anoperable restriction device adapted to be implanted in a patient toengage the colon or rectum or the prolongation thereof to form arestricted fecal passageway in the colon or rectum or the prolongationthereof, said restriction device being operable to perform a reversiblefunction, an energy transmission device for wireless transmission ofenergy from outside the patient's body, an energy transfer deviceadapted to be implanted in the patient for transferring energytransmitted by said energy transmission device into a different form ofenergy, said restriction device being operable in response to saiddifferent form of energy to vary the restriction of the restricted fecalpassageway, and a powered operation device adapted to be implanted inthe patient for operating said restriction device, wherein saiddifferent form of energy is used for powering said powered operationdevice to reversibly operate said restriction device to close the fecalpassageway to prevent feces to pass therethrough and to enlarge thefecal passageway to allow feces to readily pass therethrough.
 2. Anapparatus according to claim 1, wherein said restriction device iselectrically operated, and said different form energy comprises electricenergy.
 3. An apparatus according to claim 2, further comprisingelectric conductors connected to said energy transfer device, wherebysaid energy transfer device is capable of supplying an electric currentvia said conductors.
 4. An apparatus according to claim 3, wherein saidenergy transfer device is capable of supplying an alternating current ora combination of a direct and alternating current via said conductors.5. An apparatus according to claim 1, wherein said energy transferdevice is capable of supplying a frequency, amplitude or frequency andamplitude modulated signal.
 6. An apparatus according to claim 1,wherein said energy transfer device is capable of supplying an analog,digital or a combination of an analog and digital signal.
 7. Anapparatus according to claim 1, wherein said operation device comprisesa motor.
 8. An apparatus according to claim 7, further comprising acontrol device, wherein said motor comprises a rotary motor, and saidcontrol device controls said rotary motor to rotate a desired number ofrevolutions.
 9. An apparatus according to claim 1, further comprising acontrol device for controlling said operation device.
 10. An apparatusaccording to claim 1, wherein said operation device comprises anelectric motor and said different form energy comprises electric energy.11. An apparatus according to claim 1, further comprising a reversingdevice adapted to be implanted in the patient for reversing saidfunction performed by said restriction device.
 12. An apparatusaccording to claim 11, wherein said control device controls saidreversing device to reverse said function performed by said restrictiondevice.
 13. An apparatus according to claim 1, wherein said energytransfer device comprises at least one semiconductor.
 14. An apparatusaccording to claim 1, further comprising an energy storage deviceadapted to be implanted in the patient for storing said different formof energy and for supplying energy for operation of said restrictiondevice.
 15. An apparatus according to claim 14, wherein said energystorage device comprises an accumulator.
 16. An apparatus according toclaim 15, wherein said different form of energy comprises electricenergy and said energy storage device comprises an electric accumulator.17. An apparatus according to claim 16, wherein said electricaccumulator comprises at least one capacitor or at least onerechargeable battery.
 18. An apparatus according to claim 14, furthercomprising a switch adapted to be implanted in the patient for directlyor indirectly switching the operation of said restriction device.
 19. Anapparatus according to claim 18, further comprising a source of energyadapted to be implanted in the patient, wherein said switch is operatedby said different form of energy supplied by said energy storage deviceto switch from an off mode, in which said source of energy is not inuse, to an on mode, in which said source of energy supplies energy forthe operation of said restriction device.
 20. An apparatus according toclaim 18, further comprising a source of energy adapted to be implantedin the patient, and a remote control for controlling the supply ofenergy of said source of energy, wherein said switch is operated by saiddifferent form energy supplied by said energy storage device to switchfrom an off mode, in which said remote control is prevented fromcontrolling said source of energy and said source of energy is not inuse, to a standby mode, in which said remote control is permitted tocontrol said source of energy to supply energy for the operation of saidrestriction device.
 21. An apparatus according to claim 1, furthercomprising a switch adapted to be implanted in the patient for switchingthe operation of said restriction device.
 22. An apparatus according toclaim 21, further comprising a source of energy adapted to be implantedin the patient for supplying energy for the operation of saidrestriction device, wherein said switch is operated by said differentform energy supplied by said energy transfer device to switch from anoff mode, in which said source of energy is not in use, to an on mode,in which said source of energy supplies energy for the operation of saidrestriction device.
 23. An apparatus according to claim 21, furthercomprising a source of energy adapted to be implanted in the patient forsupplying energy for the operation of said restriction device, and aremote control for controlling the supply of energy of said implantedsource of energy, wherein said switch is operated by said different formenergy supplied by said energy transfer device to switch from an offmode, in which said remote control is prevented from controlling saidsource of energy and said source of energy is not in use, to a standbymode, in which said remote control is permitted to control said sourceof energy to supply energy for the operation of said restriction device.24. An apparatus according to claim 1, wherein said energy transmissiondevice transmits the energy by at least one wireless signal.
 25. Anapparatus according to claim 24, wherein said signal comprises a wavesignal.
 26. An apparatus according to claim 24, wherein said signalcontains radiant energy.
 27. An apparatus according to claim 25, whereinsaid wave signal comprises an electromagnetic wave signal including oneof an infrared light signal, a visible light signal, an ultra violetlight signal, a laser signal, a micro wave signal, a radio wave signal,an x-ray radiation signal, and a gamma radiation signal.
 28. Anapparatus according to claim 25, wherein said wave signal comprises asound wave signal.
 29. An apparatus according to claim 24, wherein saidsignal comprises a digital or analog signal, or a combination of adigital and analog signal.
 30. An apparatus according to claim 1,wherein the energy transmitted by said energy transmission devicecomprises an electric field.
 31. An apparatus according to claim 30,wherein said electric field is transmitted in pulses or digital pulses,or a combination of pulses and digital pulses by said energytransmission device.
 32. An apparatus according to claim 1, furthercomprising a pulse generator adapted to be implanted in the patient forgenerating electrical pulses from said different form energy.
 33. Anapparatus according to claim 1, further comprising at least one sensoradapted to be implanted in the patient for sensing at least one physicalparameter of the patient.
 34. An apparatus according to claim 33,wherein said sensor comprises a pressure sensor for directly orindirectly sensing the pressure in said fecal passageway.
 35. Anapparatus according to claim 33, further comprising a control device forcontrolling said restriction device in response to signals from saidsensor.
 36. An apparatus according to claim 35, wherein said controldevice comprises an internal control unit adapted to be implanted in thepatient for controlling said restriction device in response to signalsfrom said sensor.
 37. An apparatus according to claim 35, wherein saidinternal control unit directly controls said restriction device inresponse to signals from said sensor.
 38. An apparatus according toclaim 35, wherein said control device comprises an external control unitoutside the patient's body for controlling said restriction device inresponse to signals from said sensor.
 39. An apparatus according toclaim 38, wherein said external control unit stores information on saidphysical parameter sensed by said sensor and is manually operated tocontrol said restriction device based on said stored information.
 40. Anapparatus according to claim 1, further comprising a wireless remotecontrol transmitting at least one wireless control signal forcontrolling said restriction device.
 41. An apparatus according to claim40, wherein said remote control comprises a control unit adapted to beimplanted in the patient for controlling said restriction device.
 42. Anapparatus according to claim 41, wherein said control unit comprises amicroprocessor.
 43. An apparatus according to claim 40, wherein saidwireless remote control comprises at least one external signaltransmitter and at least one internal signal receiver adapted to beimplanted in the patient.
 44. An apparatus according to claim 40,wherein said wireless remote control comprises at least one externalsignal receiver and at least one internal signal transmitter adapted tobe implanted in the patient.
 45. An apparatus according to claim 40,wherein said remote control is capable of sending information related tosaid restriction device from inside the patient's body to the outsidethereof.
 46. An apparatus according to claim 45, wherein said remotecontrol controls said restriction device in response to saidinformation.
 47. An apparatus according to claim 40, wherein said remotecontrol comprises a control signal transmitter for transmiffing saidcontrol signal, and said energy transmission device comprises saidcontrol signal transmitter, whereby the energy transmitted by saidenergy transmission device is transmitted by said control signal.
 48. Anapparatus according to claim 40, wherein said energy transmission devicetransmits the energy by at least one signal separate from said controlsignal.
 49. An apparatus according to claim 40, wherein said remotecontrol transmits a carrier signal for carrying said control signal. 50.An apparatus according to claim 40, wherein said energy transmissiondevice transmits the energy by at least one signal, which is used as acarrier signal for said control signal transmifted by said remotecontrol.
 51. An apparatus according to claim 50, wherein said carriersignal is frequency, amplitude or frequency and amplitude modulated. 52.An apparatus according to claim 50, wherein said carrier signalcomprises digital, analog or a combination of digital and analog waves.53. An apparatus according to claim 50, wherein said control signal usedwith said carrier signal is frequency, amplitude or frequency andamplitude modulated.
 54. An apparatus according to claim 50, whereinsaid control signal used with said carrier signal is digital, analog orcombined digital and analog.
 55. An apparatus according to claim 40,wherein said control signal comprises a wave signal comprising one of asound wave signal including an ultrasound wave signal, anelectromagnetic wave signal including an infrared light signal, avisible light signal, an ultra violet light signal and a laser lightsignal, a micro wave signal, a radio wave signal, an x-ray radiationsignal, and a gamma radiation signal.
 56. An apparatus according toclaim 40, wherein said control signal comprises an electric or magneticfield, or a combined electric and magnetic field.
 57. An apparatusaccording to claim 40, wherein said control signal comprises a digital,analog or combined digital and analog control signal.
 58. An apparatusaccording to claim 57, wherein said remote control transmits anelectromagnetic carrier wave signal for carrying said digital or analogcontrol signal.
 59. An apparatus according to claim 1, wherein saiddifferent form energy used for operating said restriction device iswirelessly transmitted by said energy transfer device.
 60. An apparatusaccording to claim 1, further comprising a control unit adapted to beimplanted in the patient for controlling said restriction device.
 61. Anapparatus according to claim 60, wherein said control unit isprogrammable for controlling said restriction device in accordance witha program.
 62. An apparatus according to claim 61, further comprising anexternal wireless remote control for programming said control unit. 63.An apparatus according to claim 1, wherein said restriction devicecontrols the cross-sectional area of the fecal passageway.
 64. Anapparatus according to claim 1, wherein one of the energy transmitted bysaid energy transmission device and said different form energy compriseselectromagnetic energy.
 65. An apparatus according to claim 1, whereinsaid energy transmission device functions differently from said energytransfer device.
 66. An apparatus according to claim 1, wherein saidenergy transmission device functions similar to said energy transferdevice.
 67. An apparatus according to claim 1, wherein said restrictiondevice is directly operated with said different form energy, as saidenergy transmission device transmits energy.
 68. An apparatus accordingto claim 67, wherein said energy transfer device directly operates saidrestriction device with said different form energy in a non-magneticmanner.
 69. An apparatus according to claim 67, wherein said energytransfer device directly operates said restriction device with saiddifferent form energy in a non-mechanical manner.
 70. An apparatusaccording to claim 1, wherein said energy transfer device is adapted tobe implanted subcutaneously or in the abdomen of the patient.
 71. Alaparoscopical implanting method, comprising the steps of: providing ananal incontinence disease treatment apparatus according to claim 1,placing at least two laparoscopic cannula within a patient's body, andimplanting the energy transfer device in the patient's body by using theat least two laparoscopic cannula.
 72. An anal incontinence diseasetreatment apparatus, comprising: an operable restriction device adaptedto be implanted in a patient to engage the colon or rectum or theprolongation thereof to form a restricted fecal passageway in the colonor rectum or the prolongation thereof, an energy transmission device forwireless transmission of energy from outside the patient's body, anenergy transfer device adapted to be implanted in the patient fortransferring energy transmitted by said energy transmission device intoa different form energy, an energy storage device adapted to beimplanted in the patient for storing said different form energy and forsupplying energy for operation of said restriction device, and a switchadapted to be implanted in the patient for directly or indirectlyswitching the supply of energy from said energy storage device, whereinsaid switch is inoperable by permanent magnets.
 73. An apparatusaccording to claim 72, further comprising an operation device adapted tobe implanted in the patient for operating said restriction device. 74.An apparatus according to claim 73, wherein said operation devicecomprises a motor.
 75. An apparatus according to claim 72, wherein saidrestriction device is operable to perform a reversible function.
 76. Anapparatus according to claim 75, further comprising a reversing deviceadapted to be implanted in the patient for reversing said functionperformed by said restriction device.
 77. An anal incontinence diseasetreatment apparatus, comprising: an operable restriction device adaptedto be implanted in a patient to engage the colon or rectum or theprolongation thereof to form a restricted fecal passageway in the colonor rectum or the prolongation thereof, an energy transmission device forwireless transmission of energy from outside the patient's body, anenergy transfer device adapted to be implanted in the patient fortransferring energy transmitted by said energy transmission device intoa different form of energy, a switch adapted to be implanted in thepatient for switching the operation of said restriction device, and asource of energy adapted to be implanted in the patient for supplyingenergy for the operation of said restriction device, wherein said switchis operable by said different form of energy supplied by said energytransfer device to switch from an off mode, in which said source ofenergy is not in use, to an on mode, in which said source of energysupplies energy for the operation of said restriction device.
 78. Ananal incontinence disease treatment apparatus, comprising: an operablerestriction device adapted to be implanted in a patient to engage thecolon or rectum or the prolongation thereof to form a restricted fecalpassageway in the colon or rectum or the prolongation thereof, an energytransmission device for wireless transmission of energy from outside thepatient's body, an energy transfer device adapted to be implanted in thepatient for transferring energy transmitted by said energy transmissiondevice into a different form of energy, a switch adapted to be implantedin the patient for switching the operation of said restriction device, asource of energy adapted to be implanted in the patient for supplyingenergy for the operation of said restriction device, and a remotecontrol for controlling the supply of energy of said source of energy,wherein said switch is operable by said different form energy suppliedby said energy transfer device to switch from an off mode, in which saidremote control is prevented from controlling said source of energy andsaid source of energy is not in use, to a standby mode, in which saidremote control is permitted to control said source of energy to supplyenergy for the operation of said restriction device.
 79. An analincontinence disease treatment apparatus, comprising: an operablerestriction device adapted to be implanted in a patient to engage thecolon or rectum or the prolongation thereof to form a restricted fecalpassageway in the colon or rectum or the prolongation thereof, an energytransmission device for wireless transmission of energy from outside thepatient's body, an energy transfer device adapted to be implanted in thepatient for transferring energy transmitted by said energy transmissiondevice into a different form energy, wherein said restriction device isadapted to be directly and reversibly operated to vary the restrictionof the restricted fecal passageway, in response to said different formenergy transferred by said energy transfer device, as said energytransmission device transmits energy.
 80. An apparatus according toclaim 79, further comprising an operation device adapted to be implantedin the patient for operating said restriction device.
 81. An apparatusaccording to claim 80, wherein said operation device comprises a motor.82. An apparatus according to claim 79, wherein said restriction deviceis operable to perform a reversible function and further comprising areversing device adapted to be implanted in the patient for reversingsaid function performed by said restriction device.
 83. An apparatusaccording to claim 79, wherein said different form energy compriseselectric energy.
 84. An anal incontinence disease treatment apparatus,comprising: an operable restriction device adapted to be implanted in apatient to engage the colon or rectum or the prolongation thereof toform a restricted fecal passageway in the colon or rectum or theprolongation thereof, a source of energy adapted to be implanted in thepatient for supplying energy to be used in connection with the operationof said restriction device, an energy transfer device for transferringwireless energy into an energy form suited for charging said source ofenergy, a control device operable from outside the patient's body tocontrol said energy transfer device to charge said internal source ofenergy with transferred wireless energy and to control said source ofenergy to release energy, and at least one implantable sensor forsensing at least one physical parameter of the patient, wherein saidcontrol device comprises a first, external control unit operable fromthe outside of the patient's body for providing a control signal andsecond electrical internal control unit adapted to be implanted in thepatient, said internal control unit directly controlling saidrestriction device in response to signals from said sensor.
 85. An analincontinence disease treatment apparatus, comprising: an operablerestriction device adapted to be implanted in a patient to engage thecolon or rectum or the prolongation thereof to form a restricted fecalpassageway in the colon or rectum or the prolongation thereof, a sourceof energy adapted to be implanted in the patient for supplying energy tobe used in connection with the operation of said restriction device, anenergy transfer device for transferring wireless energy into an energyform suited for charging said source of energy, a control deviceoperable from outside the patient's body to control said energy transferdevice to charge said internal source of energy with transferredwireless energy and to control said source of energy to release energy,and at least one implantable sensor for sensing at least one physicalparameter of the patient, wherein said control device comprises a first,external control unit operable from the outside of the patient's bodyfor providing a control signal and a second, internal control unitadapted to be implanted in the patient, said internal control unitcommunicating with said external control unit in response to signalsfrom said sensor and is adapted to control the restriction device inresponse to the control signal.
 86. An anal incontinence diseasetreatment apparatus, comprising: an operable restriction device adaptedto be implanted in a patient to engage the colon or rectum or theprolongation thereof to form a restricted fecal passageway in the colonor rectum or the prolongation thereof, a source of energy adapted to beimplanted in the patient for supplying energy to be used in connectionwith the operation of said restriction device, a control device operablefrom outside the patient's body for releasing energy from said source ofenergy, said released energy being used in connection with the operationof said restriction device, wherein said control device comprises awireless remote control transmitting at least one wireless controlsignal for controlling said restriction device to close the fecalpassageway to prevent feces from passing therethrough and enlarge thefecal passageway to allow feces to readily pass therethrough, and aninternal control unit adapted to be implanted in the patient forreceiving the wireless control signal.
 87. An anal incontinence diseasetreatment apparatus, comprising: an operable restriction device adaptedto be implanted in a patient to engage the colon or rectum or theprolongation thereof to form a restricted fecal passageway in the colonor rectum or the prolongation thereof, an implantable powered operationdevice for operating said restriction device, a source of energyexternal to the patient's body, a control device operable from outsidethe patient's body to control said external source of energy to releasewireless energy, an implantable energy transfer device adapted totransfer said wireless energy into storable energy, and an implantableinternal source of energy adapted to store said storable energy andpower said operation device with said storable energy, wherein saidcontrol device comprises a wireless remote control transmitting at leastone wireless control signal for controlling said restriction device toclose the fecal passageway to prevent feces from passing therethroughand enlarge the fecal passageway to allow feces to readily passtherethrough, and an internal control unit adapted to be implanted inthe patient for recevint the wireless control signal.
 88. An apparatusaccording to claim 87, wherein said control device comprises an internalcontrol unit adapted to be implanted in the patient for controlling saidrestriction device.
 89. An apparatus according to claim 88, wherein saidinternal control unit is programmable.
 90. An apparatus according toclaim 89, wherein said control device comprises an external control unitoutside the patient's body, said internal control unit beingprogrammable by said external control unit.
 91. An apparatus accordingto claim 89, wherein said internal control unit is programmable forcontrolling said restriction device over time.
 92. An apparatusaccording to claim 91, wherein said internal control unit comprises amicroprocessor.
 93. An apparatus according to claim 90, wherein saidexternal control unit loads said internal control unit with data inaccordance with a loading mode only authorized for a doctor.
 94. Anapparatus according to claim 90, wherein said external control unitcontrols said internal control unit in accordance with a doctor modeonly authorized for a doctor.
 95. An apparatus according to claim 90,wherein said external control unit controls said internal control unitin accordance with a patient mode permitted for the patient.
 96. Anapparatus according to claim 87, wherein said operation device isadapted to be directly powered with said storable energy as said energytransfer device transfers said wireless energy into said storableenergy.
 97. An apparatus according to claim 96, wherein said wirelessenergy is directly used for operation of said restriction device in anon-mechanical manner.
 98. An apparatus according to claim 96, furthercomprising an operation device for operating said restriction device,wherein said wireless energy directly or indirectly powers saidoperation device.
 99. An apparatus according to claim 96, wherein saidoperation device comprises a motor.
 100. An apparatus according to claim99, wherein said motor comprises a rotary motor, and said control devicecontrols said rotary motor to rotate a desired number of revolutions.101. An apparatus according to claim 99, wherein said motor comprises alinear motor.
 102. An apparatus according to claim 96, wherein saidoperation device comprises an electric motor and said released energycomprises electric energy.
 103. An apparatus according to claim 96,wherein said restriction device is operable by said operation device toperform a reversible function.
 104. An apparatus according to claim 103,further comprising a reversing device adapted to be implanted in thepatient for reversing said function performed by said restrictiondevice.
 105. An apparatus according to claim 104, wherein said controldevice controls said reversing device to reverse said function performedby said restriction device.
 106. An apparatus according to claim 104,wherein said operation device comprises a motor, and said reversingdevice reverses said motor.
 107. An apparatus according to claim 87,further comprising a switch adapted to be implanted in the patient fordirectly or indirectly switching the operation of said restrictiondevice.
 108. An apparatus according to claim 107, wherein said switchdirectly or indirectly affects the supply of energy from said internalsource of energy.
 109. An apparatus according to claim 108, wherein saidswitch switches between an “off” mode, in which said internal source ofenergy is not in use, and an “on” mode, in which said internal source ofenergy supplies energy for the operation of said restriction device.110. An apparatus according to claim 109, wherein said switch isoperable by said wireless energy released from said external source ofenergy.
 111. An apparatus according to claim 110, wherein said controldevice comprises a wireless remote control.
 112. An apparatus accordingto claim 108, wherein said control device comprises a wireless remotecontrol for controlling said internal source of energy.
 113. Anapparatus according to claim 112, wherein said switch is operable bysaid wireless energy from said external source of energy to switchbetween an “off” mode, in which said internal source of energy andremote control are not in use, and a “standby” mode, in which saidremote control is permitted to control said internal source of energy tosupply energy for the operation of said restriction device.
 114. Anapparatus according to claim 108, further comprising an energy storagedevice adapted to be implanted in the patient for storing said storableenergy.
 115. An apparatus according to claim 114, wherein said switch isoperable by energy from said energy storage device to switch between an“off” mode, in which said internal source of energy is not in use, andan “on” mode, in which said internal source of energy supplies energyfor the operation of said restriction device.
 116. An apparatusaccording to claim 115, wherein said control device controls said energystorage device to operate said switch.
 117. An apparatus according toclaim 116, wherein said control device comprises a wireless remotecontrol.
 118. An apparatus according to claim 108, wherein said switchswitches from an “off” mode, in which said internal source of energy isnot in use, to an “on” mode, in which said internal source of energysupplies energy for the operation of said restriction device.
 119. Anapparatus according to claim 118, wherein said control device controlssaid switch to switch between said “on” and “off” modes.
 120. Anapparatus according to claim 119, wherein said control device comprisesa wireless remote control.
 121. An apparatus according to claim 109,wherein said internal source of energy comprises an electric source ofenergy.
 122. An apparatus according to claim 121, wherein said electricsource of energy comprises at least one accumulator, at least onecapacitor or at least one rechargeable battery, or a combination of atleast one capacitor and at least one rechargeable battery.
 123. Anapparatus according to claim 107, wherein said control device controlssaid operation device.
 124. An apparatus according to claim 123, whereinsaid operation device comprises a motor.
 125. An apparatus according toclaim 124, wherein said motor comprises a rotary motor, and said controldevice controls said rotary motor to rotate a desired number ofrevolutions.
 126. An apparatus according to claim 124, wherein saidmotor comprises a linear motor.
 127. An apparatus according to claim124, wherein said operation device comprises an electric motor and saidstorable energy comprises electric energy.
 128. An apparatus accordingto claim 123, wherein said restriction device is operable to perform areversible function.
 129. An apparatus according to claim 128, furthercomprising a reversing device adapted to be implanted in the patient forreversing said function performed by said restriction device.
 130. Anapparatus according to claim 129, wherein said control device controlssaid reversing device to reverse said function performed by saidrestriction device.
 131. An apparatus according to claim 129, whereinsaid operation device comprises a motor, and said reversing devicereverses said motor.
 132. An apparatus according to claim 87, furthercomprising at least one sensor adapted to be implanted in the patientfor sensing at least one physical parameter of the patient.
 133. Anapparatus according to claim 132, wherein said sensor comprises apressure sensor for directly or indirectly sensing the pressure in saidfecal passageway.
 134. An apparatus according to claim 132, wherein saidcontrol device controls said restriction device in response to signalsfrom said sensor.
 135. An apparatus according to claim 134, wherein saidcontrol device comprises an internal control unit adapted to beimplanted in the patient, said internal control unit controlling saidrestriction device in response to signals from said sensor.
 136. Anapparatus according to claim 134, wherein said control device comprisesan external control unit controlling said restriction device in responseto signals from said sensor.
 137. An apparatus according to claim 136,wherein said external control unit stores information on said physicalparameter sensed by said sensor and is manually operated to control saidrestriction device based on said stored information.
 138. An apparatusaccording to claim 87, wherein said restriction device controls thecross-sectional area of said fecal passageway.
 139. An apparatusaccording to claim 138, wherein said restriction device is operable toopen and close said fecal passageway.
 140. An apparatus according toclaim 138, wherein said restriction device steplessly controls thecross-sectional area of said fecal passageway.
 141. An apparatusaccording to claim 87, wherein said control device releases wirelesselectric energy and said energy transfer device transfers said electricenergy into kinetic energy for operation of said restriction device.142. An apparatus according to claim 141, wherein said restrictiondevice is directly operated with said kinetic energy, as said energytransfer device transfers said electric energy into said kinetic energy.143. An apparatus according to claim 87, wherein said control devicereleases energy for a determined time period.
 144. An apparatusaccording to claim 87, wherein said control device releases energy fromsaid external source of energy in a non-invasive manner.
 145. Anapparatus according to claim 87, wherein said control device comprises awireless remote control transmitting at least one wireless controlsignal for controlling said restriction device.
 146. An apparatusaccording to claim 145, wherein said wireless remote control comprisesat least one external signal transmitter and at least one internalsignal receiver adapted to be implanted in the patient.
 147. Anapparatus according to claim 145, wherein said wireless remote controlcomprises at least one external signal receiver and at least oneinternal signal transmitter adapted to be implanted in the patient. 148.An apparatus according to claim 145, wherein said remote control iscapable of sending information related to said restriction device frominside the patient's body to the outside thereof.
 149. An apparatusaccording to claim 148, wherein said remote control controls saidrestriction device in response to said information.
 150. An apparatusaccording to claim 145, wherein said remote control transmits a carriersignal for carrying said control signal.
 151. An apparatus according toclaim 150, wherein said carrier signal is frequency, amplitude orfrequency and amplitude modulated.
 152. An apparatus according to claim150, wherein said carrier signal is digital, analog or digital andanalog.
 153. An apparatus according to claim 150, wherein said controlsignal used with said carrier signal is frequency, amplitude orfrequency and amplitude modulated.
 154. An apparatus according to claim145, wherein said control signal comprises a wave signal comprising oneof a sound wave signal including an ultrasound wave signal, anelectromagnetic wave signal including an infrared light signal, avisible light signal, an ultra violet light signal and a laser lightsignal, a micro wave signal, a radio wave signal, an x-ray radiationsignal, and a gamma radiation signal.
 155. An apparatus according toclaim 145, wherein said control signal comprises an electric, magneticor electric and magnetic field.
 156. An apparatus according to claim145, wherein said control signal is digital, analog or digital andanalog.
 157. An apparatus according to claim 156, wherein said remotecontrol transmits an electromagnetic carrier wave signal for carryingsaid digital or analog control signal.
 158. An apparatus according toclaim 145, wherein said control signal is transmitted in pulses by saidwireless remote control.
 159. An apparatus according to claim 87,wherein said control device releases energy from said external source ofenergy in a non-invasive manner.
 160. An apparatus according to claim87, wherein said control device releases electromagnetic energy.
 161. Anapparatus according to claim 87, wherein said control device releasesenergy from said external source of energy in a non-mechanical manner.162. An anal incontinence disease treatment apparatus, comprising: anoperable restriction device adapted to be implanted in a patient toengage the colon or rectum or the prolongation thereof to form arestricted fecal passageway, an implantable powered operation device foroperating said restriction device, a source of energy external to thepatient's body, a control device operable from outside the patient'sbody to control said external source of energy to releaseelectromagnetic wireless energy for use in the powering of saidoperation device, an implantable energy transfer device for transferringsaid electromagnetic wireless energy into another form of energy usableby said operation device, wherein said control device comprises a first,external control unit operable from the outside of the body forproviding a control signal a second, internal unit adapted to controlthe restriction device in response to a control signal to close thefecal passageway to prevent feces from passing therethrough and toenlarge the fecal passageway to allow feces to readily passtherethrough.
 163. An apparatus according to claim 162, wherein saidinternal control unit comprises a microprocessor.
 164. An apparatusaccording to claim 162, wherein said electromagnetic wireless energyreleased from said external source of energy is directly, during energytransfer, used for operation of said restriction device.
 165. Anapparatus according to claim 164, wherein said wireless energy directlyor indirectly powers said operation device.
 166. An apparatus accordingto claim 164, wherein said operation device comprises a motor.
 167. Anapparatus according to claim 166, wherein said motor comprises a rotarymotor, and said control device controls said rotary motor to rotate adesired number of revolutions.
 168. An apparatus according to claim 166,wherein said motor comprises a linear motor.
 169. An apparatus accordingto claim 164, wherein said restriction device is operable by saidoperation device to perform a reversible function.
 170. An apparatusaccording to claim 169, further comprising a reversing deviceimplantable in the patient for reversing said function performed by saidrestriction device.
 171. An apparatus according to claim 170, whereinsaid control device controls said reversing device to reverse saidfunction performed by said restriction device.
 172. An apparatusaccording to claim 162, further comprising a switch implantable in thepatient for directly or indirectly switching the operation of saidrestriction device.
 173. An apparatus according to claim 162, furthercomprising at least one implantable sensor for sensing at least onephysical parameter of the patient.
 174. An apparatus according to claim173, wherein said control device controls said restriction device inresponse to signals from said sensor.
 175. An apparatus according toclaim 174, wherein said control device comprises an internal controlunit implantable in the patient, said internal control unit controllingsaid restriction device in response to signals from said sensor.
 176. Anapparatus according to claim 173, wherein said control device comprisesan external control unit that stores information on said physicalparameter sensed by said sensor and is manually operated to control saidrestriction device based on said stored information.
 177. An apparatusaccording to claim 162, wherein said control device comprises a wirelessremote control transmitting at least one wireless control signal forcontrolling said restriction device.
 178. An apparatus according toclaim 177, wherein said remote control is capable of sending informationrelated to said restriction device from inside the patient's body to theoutside thereof.
 179. An apparatus according to claim 177, wherein saidcontrol signal comprises a wave signal comprising one of a sound wavesignal including an ultrasound wave signal, an electromagnetic wavesignal including an infrared light signal, a visible light signal, anultra violet light signal and a laser light signal, a micro wave signal,a radio wave signal, an x-ray radiation signal, and a gamma radiationsignal.
 180. An apparatus according to claim 177, wherein said controlsignal comprises an electric, magnetic or electric and magnetic field.181. An apparatus according to claim 177, wherein said control signal isdigital, analog or digital and analog.
 182. An apparatus according toclaim 162, wherein said control device releases energy from saidexternal source of energy in a non-invasive manner.
 183. An apparatusaccording to claim 162, wherein said electromagnetic wireless energycomprises a wave signal comprising one of an electromagnetic wave signalincluding an infrared light signal, a visible light signal, an ultraviolet light signal and a laser light signal, a micro wave signal, aradio wave signal, an x-ray radiation signal, and a gamma radiationsignal.
 184. A method of treating anal incontinence disease, comprising:implanting in a patient an operable restriction device engaging thecolon or rectum or the prolongation thereof to form a restricted fecalpassageway in the colon or rectum or the prolongation thereof,implanting in the patient a source of electric energy for energizing therestriction device, transferring wireless energy into electric energy,charging the source of energy with the electric energy, and controllingthe source of energy from outside the patient's body to release electricenergy for use in connection with the operation of the restrictiondevice.
 185. A method according to claim 184, further comprising usingenergy released from the source of energy to operate the restrictiondevice to enlarge and contract, respectively, the fecal passageway so asto allow, or substantially prevent, the passage of fecal materialthrough the fecal passageway.
 186. A method of treating analincontinence disease, comprising the steps of: placing at least twolaparoscopical trocars in a patient's body, inserting a dissecting toolthrough the trocars and dissecting an area of the colon or rectum or theprolongation thereof, implanting an operable restriction device in thedissected area, so that the restriction device engages the colon orrectum or the prolongation thereof to form a restricted fecal passagewayin the colon or rectum or the prolongation thereof, providing anexternal source of energy, providing a control device, using the controldevice to control the external source of energy to release wirelessenergy, implanting an energy transfer device, and using the controldevice to control the energy transfer device to transfer the releasedwireless energy into electric energy for use in connection with theoperation of the restriction device.
 187. A method according to claim186, further comprising sensing at least one physical parameter of thepatient.
 188. A method according to claim 187, further comprising usingthe control device to control the restriction device in response to thesensed physical parameter.
 189. A method of treating anal incontinencedisease, comprising the steps of: placing at least two laparoscopicaltrocars in a patient's body, inserting a dissecting tool through thetrocars and dissecting an area of the colon or rectum or theprolongation thereof, placing an operable restriction device in thedissected area, so that the restriction device engages the colon orrectum or the prolongation thereof to form a restricted fecal passagewayin the colon or rectum or the prolongation thereof, implanting a sourceof electric energy in the patient, transferring wireless energy intoelectric energy, charging the source of energy with the electric energy,and controlling the implanted source of energy from outside thepatient's body to release electric energy for use in connection with theoperation of the restriction device.
 190. A method of treating a humanor animal having anal incontinence disease, comprising: (a) surgicallyimplanting in the human or animal an operable restriction deviceengaging the human's or animal's colon or rectum or the prolongationthereof to form a restricted fecal passageway in the colon or rectum orthe prolongation thereof, (b) implanting an internal source of energy,(c) providing a source of energy external to the human or animal, (d)controlling the external source of energy from outside the human oranimal to release wireless energy, (e) transferring the releasedwireless energy into storable energy and storing the storable energy inthe internal source of energy, and (f) controlling the internal sourceof energy to release energy for operating the restriction device torestrict the fecal passageway to prevent feces from passing therethroughand enlarge the fecal passageway to allow feces to readily passtherethrough.
 191. A method according to claim 190, further comprisingimplanting in the human or animal an operation device operativelyconnected to the restriction device and capable of operating therestriction device to adjust the restricted fecal passageway in responseto supplied energy.
 192. A method according to claim 191, furthercomprising using the released wireless energy to activate the implantedoperation device.
 193. A method according to claim 192, wherein theimplanted operation device is activated to enlarge the fecal passagewayat least once a day.
 194. A method according to claim 190, furthercomprising controlling the internal source of energy from outside thehuman or animal.
 195. A method of treating a human or animal having analincontinence disease, comprising: (a) surgically implanting in the humanor animal an operable restriction device engaging the human's oranimal's colon or rectum or the prolongation thereof to form arestricted fecal passageway, (b) providing a source of energy externalto the patient's body, (c) controlling the external source of energyfrom outside the patient's body to release electromagnetic wirelessenergy, (d) transferring said electromagnetic wireless energy into adifferent form of energy, (e) using said different form of energy tooperate the restriction device, and (f) controlling the restrictiondevice to restrict the fecal passageway to prevent feces from passingtherethrough and enlarge the fecal passageway to allow feces to readilypass therethrough.
 196. A method of treating a human or animal havinganal incontinence disease, comprising: (a) surgically implanting in thehuman or animal an operable restriction device engaging the human's oranimal's colon or rectum or the prolongation thereof to form arestricted fecal passageway, (b) providing a source of energy externalto the patient's body, (c) implanting a control unit in the human oranimal, (d) controlling the external source of energy from outside thepatient's body to release wireless energy, (e) transferring saidwireless energy into a different form of energy, (f) using the differentform of energy to operate the restriction device, and (g) controlling bythe implanted control unit the restriction device to restrict the fecalpassageway to prevent feces from passing therethrough and enlarge thefecal passageway to allow feces to readily pass therethrough.
 197. Amethod of treating anal incontinence disease, comprising the steps of:placing at least two laparoscopical trocars in a patient's body,inserting a dissecting tool through the trocars and dissecting an areaof the colon or rectum or the prolongation thereof, placing an operablerestriction device in the dissected area, so that the restriction deviceengages the colon or rectum or the prolongation thereof to form arestricted fecal passageway in the colon or rectum or the prolongationthereof, implanting a source of energy in the patient, and wirelesslycontrolling the implanted source of energy from outside the patient'sbody to release energy for use in connection with the operation of therestriction device.
 198. An apparatus according to claim 84 wherein saidinternal control unit directly controls said restriction device inresponse to said control signal.
 199. An apparatus according to claim86, further comprising a switch, wherein said control device controlssaid switch with a non-magnetic wireless control signal for directly orindirectly switching said energy released from said source of energy.